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Unlike in Fallout 3, the Perk Rate in Fallout: New Vegas is one perk every two levels. To counter how easy it was to max out the player's skills in Fallout 3, most of the skill-boosting perks have been removed or replaced. There are 88 regular perks, 8 companion perks, 16 challenge perks, and an unknown amount of special perks. Only regular perks may be selected during level up. Other types of perks are granted through completing various tasks, and do not count against the limit of regular perks. You can get up to a total of 25 non-challenge perks with all 4 DLCs installed. With all DLCs installed there are 117 regular perks.

Companion perks, as their name suggests, are granted by the player's companions. For example, Enhanced Sensors is only in effect while the Courier is accompanied by ED-E. The perk remains in effect so long as the companion is currently following the player. Unless the companion is dismissed, the perk will remain in effect regardless of the distance between the player and their companions. Companions told to wait are still counted as active companions.

Challenge perks are unlocked by fulfilling certain requirements. Challenge tasks can be accessed from the Pip-Boy menu; on the 'Misc' page, accessible from the 'Data' section. Most of the perks obtained this way are related to the skill or task that was completed to earn it. For example, Set Lasers for Fun increases the odds of scoring Critical Hits with energy-based energy weapons; to earn the perk, a player must do 16,000 points of damage with one handed energy weapons over the course of their game. Additionally, some challenge perks have multiple ranks or more than one version, such as Caza-Death Dealer, which 'level up' as the player continues adding to its requisite challenge task.

Special perks are granted from other sources, usually through actions in the game world. Completing quests and performing certain actions unlock them. For example, the effects of surgical implants are counted as special perks, which are unlocked once the implant is purchased.

Many of the perks not originally intended to be used in New Vegas remain from the conversion from Fallout 3. This means that some of the Fallout 3 perks can be added to the characters in New Vegas even though the associated quest does not exist in the game. Like Barkskin, or Wired Reflexes.

You gain a non-addictive subdermal turbo (chem) injector. This perk may be taken twice, with the second rank increasing the effect from 2 to 3 seconds and the uses per day from 5 to 10 (activated in the Pip-Boy inventory).